Take Our LASIK Quiz

The only way to know if you’re a true candidate for LASIK is to have a thorough professional evaluation. Use this self-evaluation to get a clearer idea of whether LASIK is right for you. Fill in your contact information, answer every question and hit submit, and one of our LASIK counselors will contact you within one business day.

Your Name

Your Phone Number

Your Email

Do you wear glasses or contact lenses?

Glasses Contacts Both None

If you wear contacts, check all that apply:

Soft/disposable contact lenses Rigid gas permeable contact lenses Hard contact lenses N/A

Are you in good general health?

Yes No

What is your age?

Have you ever had eye surgery?

Yes No

Have you ever had any eye injuries or diseases?

Yes No

Have you ever been diagnosed with cataracts?

Yes No

Which of the following conditions do you have (select all that apply)?

Myopia (Nearsightedness) Hyperopia (Farsightedness) Astigmatism

How well do you see at night?

Very Well OK, but could be better Poorly

Do you use reading glasses or bifocals?

Yes No

Which is the most important issue for you regarding LASIK?

Affordability Safety Experience of doctor Being free of my glasses or contacts

Do you know what is involved in a LASIK procedure?

Yes Possibly No

Are you concerned that the risks outweigh the benefits of LASIK?

Yes Possibly No

Have you ever had a LASIK evaluation before?

Yes No

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